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Risk of distal embolization and infarction with transluminal extraction atherectomy in saphenous vein grafts and native coronary arteries. NACI Investigators. New Approaches to Coronary Interventions.

Publication ,  Journal Article
Moses, JW; Moussa, I; Popma, JJ; Sketch, MH; Yeh, W
Published in: Catheter Cardiovasc Interv
June 1999

Lower success rates have been reported when treating high-risk lesions in saphenous vein grafts (SVGs) and native coronary arteries with balloon angioplasty. The transluminal extraction atherectomy catheter (TEC) has been proposed to reduce the incidence of distal embolization (DE) in subsets of high-risk lesions. To define the utility of TEC in reducing the incidence of DE, all patients who were enrolled in the New Approaches to Coronary Interventions (NACI) Registry and had TEC planned as the sole treatment were studied (329 patients with 381 lesions). Of the lesions treated, 75.9% were in SVGs; 37.5% were thrombotic; and 15% were total occlusions. Adjunctive percutaneous transluminal coronary angioplasty (PTCA) was performed in 87.4% of lesions. Multivariate predictors of DE were: noncardiac disease, stand alone TEC, thrombus, and larger vessel size. DE was associated with an 18.5% in-hospital mortality vs. 3.0% without DE (P < 0.01) and a 25.9% MI rate vs. 5.0% without DE (P < 0.01). In conclusion, in this high-risk subset of patients, TEC is associated with an 8.3% incidence of DE with thrombotic and SVGs lesions. DE associated with TEC appears to carry high morbidity and mortality. Additional techniques to control DE are needed to reduce the frequency of complications in these patients.

Duke Scholars

Published In

Catheter Cardiovasc Interv

DOI

ISSN

1522-1946

Publication Date

June 1999

Volume

47

Issue

2

Start / End Page

149 / 154

Location

United States

Related Subject Headings

  • Treatment Outcome
  • Transplantation, Autologous
  • Saphenous Vein
  • Retrospective Studies
  • Registries
  • Postoperative Complications
  • Myocardial Infarction
  • Male
  • Humans
  • Graft Occlusion, Vascular
 

Citation

APA
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ICMJE
MLA
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Moses, J. W., Moussa, I., Popma, J. J., Sketch, M. H., & Yeh, W. (1999). Risk of distal embolization and infarction with transluminal extraction atherectomy in saphenous vein grafts and native coronary arteries. NACI Investigators. New Approaches to Coronary Interventions. Catheter Cardiovasc Interv, 47(2), 149–154. https://doi.org/10.1002/(SICI)1522-726X(199906)47:2<149::AID-CCD3>3.0.CO;2-Z
Moses, J. W., I. Moussa, J. J. Popma, M. H. Sketch, and W. Yeh. “Risk of distal embolization and infarction with transluminal extraction atherectomy in saphenous vein grafts and native coronary arteries. NACI Investigators. New Approaches to Coronary Interventions.Catheter Cardiovasc Interv 47, no. 2 (June 1999): 149–54. https://doi.org/10.1002/(SICI)1522-726X(199906)47:2<149::AID-CCD3>3.0.CO;2-Z.
Moses, J. W., et al. “Risk of distal embolization and infarction with transluminal extraction atherectomy in saphenous vein grafts and native coronary arteries. NACI Investigators. New Approaches to Coronary Interventions.Catheter Cardiovasc Interv, vol. 47, no. 2, June 1999, pp. 149–54. Pubmed, doi:10.1002/(SICI)1522-726X(199906)47:2<149::AID-CCD3>3.0.CO;2-Z.
Journal cover image

Published In

Catheter Cardiovasc Interv

DOI

ISSN

1522-1946

Publication Date

June 1999

Volume

47

Issue

2

Start / End Page

149 / 154

Location

United States

Related Subject Headings

  • Treatment Outcome
  • Transplantation, Autologous
  • Saphenous Vein
  • Retrospective Studies
  • Registries
  • Postoperative Complications
  • Myocardial Infarction
  • Male
  • Humans
  • Graft Occlusion, Vascular